2024-10-18 / News
Guest article by Stephanie Ernst, Founder of Dutch partner parent organisation “The TAPS Support Foundation”, and Monique Oude Reimers-van Kilsdonk, Senior NIDCAP Trainer at Erasmus MC Hospital, The Netherlands.
© TAPS Support Foundation
We all know the incredible potential of the European Standards of Care for Newborn Health (ESCNH). These standards have the power to transform care for newborns across Europe, which is why we’re passionate about seeing them implemented—especially because they’re not fully in place yet. But that got us thinking: what about twins and other multiples? Could these standards also benefit them, even though they don’t specifically address the unique challenges of multiple births?
This question led us to submit an abstract to the 7th World Congress on Twin Pregnancy and the 19th Congress of the International Society of Twin Studies (ISTS), and we were thrilled when it was accepted as a poster! Our goal was to highlight that while the ESCNH doesn’t have specific guidelines for multiples, these babies and their families can still benefit from the existing standards.
Our abstract, titled “Improving Multiple Birth Outcomes: What Role Could the European Standards of Care for Newborn Health Play?”, explores how these standards can help improve outcomes for twins, triplets, and other multiples. Babies from multiple births often face higher risks than singletons—they are more likely to be born preterm, have low birth weight, or experience complications like twin-to-twin transfusion syndrome (TTTS) and growth discordance. In fact, around 60% of twins are born prematurely, and the numbers are even higher for triplets and quadruplets. These babies are also more likely to need neonatal intensive care (NICU) support, which increases the risk of neurodevelopmental challenges as they grow.
The ESCNH, developed by the European Foundation for the Care of Newborn Infants (EFCNI), consists of 11 key areas designed to improve outcomes for preterm and high-risk newborns across Europe. However, as our abstract highlights, these guidelines don’t specifically address the unique needs of multiple births—a crucial gap considering the higher risks these babies face.
So, what can be done? While the ESCNH doesn’t yet include specific standards for multiples, we believe that several of the existing guidelines could still make a big difference. Two areas in particular stand out: Infant- and family-centered developmental care, and Follow-up and continuing care.
The Infant and family-centered developmental care standards focus on involving families in the care of their newborns, which is critical for all infants, but especially for multiples. This standard includes practices like Kangaroo Mother Care (KMC), where parents have skin-to-skin contact with their babies. For twins and triplets in the NICU, KMC can be a game-changer—it helps regulate the babies’ temperatures, encourages breastfeeding, and promotes bonding, all of which are even more crucial when parents are juggling the needs of more than one newborn.
The Follow-up and continuing care standards are equally important. Multiples are at a higher risk for developmental delays and health complications, so structured follow-up care is vital after they leave the NICU. This care involves monitoring their growth, feeding, and development, as well as providing mental health support for parents who may face increased emotional and psychological stress. Having a coordinated team of healthcare providers to guide families through this journey ensures that both the babies and their parents get the care and support they need.
Our abstract concludes by emphasising that while the ESCNH is already a strong framework for improving newborn care, there’s a clear opportunity to enhance it further by specifically addressing the needs of multiples. By expanding these guidelines, healthcare providers could be better equipped to manage the unique medical, emotional, and psychological challenges that come with caring for twins, triplets, and higher-order multiples. This would not only reduce health risks but also improve long-term developmental outcomes and provide much-needed support for families.
In short, while the ESCNH already makes a big difference, tailoring these standards to the unique needs of multiples could have an even greater impact. By giving healthcare teams the tools to provide targeted care, we can help ensure better, healthier outcomes for both babies and their families—because when it comes to twins, triplets, and beyond, they deserve the very best start in life.
